Why does an orthotic work instead of an exercise for hammertoe?

Question

Hammertoes form when one or both joints of the small toes bend from weakness in your foot muscle. Diabetic nerve damage may cause the weakness. - NIH

I've heard from fellow runners that wearing shoes too tight contributes to developing hammertoe over time.

You may get sores on the bottoms of your feet and on the tops of your toes that can become infected. The shape of your feet may change. You can have problems walking and finding shoes that fit well.

This link mentions that you may need surgery to correct a hammer toe, but that an orthotic could work too. Shouldn't there be toe-exercises or something instead, if it's a muscle issue?

Answer 1

It depends on whether the hammer toes are due to functional problems or are fixed. If the proximal interphalangeal joint can be passively extended, then an orthotic can help. If the passive issue is neurological then exercises won't help as they won't be able to maintain the joint in the correct position when you're not doing the exercise, and you're not correcting the underlying problem. A tendon transfer operation can be used for passive problems.

But if it's due to a contracture of the joint when you can no longer extend the joint then you'll need surgery.

http://www.joint-pain-expert.net/hammer-toe.html